The news headlines took my breath away. “Trump has a forty percent chance of becoming President.” “Clinton plummeting in the polls, Trump gaining momentum.” I was certain Hillary would win in a landslide and everyone would see the emperor without his clothes on. It was just not possible for this guy to be elected by the people. How could I have been so wrong?

Watching thousands of fervent "Trumpeters" cheering him on, I was dumb struck, a song playing in my head.

“Do you see what I see?” (Guess not)
“Do you hear what I hear?” (Guess not)
“Do you feel what I feel?” (Guess not)


I couldn’t square what I saw happening. Lots of deep thoughts and deep breaths and “what-ifs,” shaken to the core by worst case possibilities. Imagining Trump's victory left me in endless dread, suffocating in apocalyptic darkness.


Being someone who lives and breathes therapy, I was able to shift my vantage point and see everything that was happening through a clinical lens. For a year, Trump bombarded us with clinical red flags screaming for action. I was surprised more mental health practitioners didn't address these pathological symptoms and their implications for fitness and risk.


I remember my shock and dismay when I was watching a CNN interview with Trump's enlisted psychologist who claimed Trump showed no pathology whatsoever, that "his only problem is addiction to truth." That sounded absurd to me. This person was obviously not credible, grossly biased and clinically baseless.


As warning signals continue flashing, more mental health professionals begin addressing Trump’s unfitness and the grave risks he poses. Just as Paul Revere did two centuries ago, it’s today's mental health community who bears the responsibility to sound the alarm when there are threats to public safety by illuminating when someone is unfit for duty and the multitude of dangers and risks an unfit President poses. Society needs training on assessing psychological fitness and risk to make informed voting decisions.


Important to note that us clinicians have our hands tied when it comes to doing psychological tests (or fitness for duty evaluations) on a public figure as any assessment must be unofficial and based entirely on public conduct. As a result, we have to be abbreviated and restrained, despite how clearly unfit Trump was deemed to be and all that was at stake if he becomes President.


(Due to the American Psychiatric Association's Goldwater Rule (1964), which invalidates clinical assessments made outside traditional office settings. This rule prohibits professionals from using the wealth of publicly available information—interviews, speeches, and behavior—as diagnostic sources.)*


A Psychological Evaluation

While it’s impossible to diagnose someone without a direct clinical assessment, Trump’s public behavior provides more than enough data to draw troubling conclusions. Based on his conduct, he exhibits clear traits of severe narcissism (referred to as a “malignant narcissist,”) and sociopathy, scoring off the charts on both, as well as, paranoid and delusional — an extraordinarily dangerous combination for a leader with a “dangerous disability.”

Narcissistic traits include:

1. Grandiose self-importance and superiority complexes.

2. Exaggeration of achievements with expectations of unwarranted admiration.

3. Exploitative behavior and lack of empathy.

4. Entitlement and arrogant attitudes.

5. Arrogant, haughty behavior

6. Lack of self-awareness or awareness of impact on others


An example you might remember: In an interview with Leslie Stahl, Trump claimed "America needs someone who can make deals that benefit America, and I'm the best dealmaker." When Stahl commented on his lack of humility, he interrupted: "I think I am humble. I think I'm much more humble than you would understand"—the opposite of a humble response.

Sociopathic tendencies are equally evident:

1. Pathological lying, woven seamlessly into his persona.

2. A pervasive disregard for others’ rights, evidenced by racist, sexist, and xenophobic rhetoric.

3. Impulsive, reckless statements like “bombing the shit out of ISIS.”

4. A lack of remorse, as shown in his response to the Access Hollywood tape and the allegations of predatory behavior that followed.

5. Lack of self-awareness or awareness of impact on others



More severe disorders mean greater emotional instability, affecting temperament and judgment. The presidency requires specific skills, knowledge, and experience. Trump may be unfit for president yet fit to run a corporation, which demands different skills. For President, we need baseline stability, sound judgment amid chaos, and diplomatic skill.



Trump's extreme egotism and superiority make him believe he alone can "make America great again" without a team—demonstrating no understanding of diplomacy or teamwork.

Among Trump's infamous statements: building a wall Mexico would pay for, claiming he could "stand in the middle of Fifth Avenue and shoot somebody without losing a voter. (which ironically may be true given how popular he is and so many people giving him a pass or normalizing whatever he does or says).
Defense Secretary Robert Gates put it bluntly: “Trump is stubbornly uninformed about the world, temperamentally unsuited to lead, and unfit to be commander-in-chief.”

Trump's defining characteristic is his extreme narcissism. He acts superior to everyone, filtering everything through self-aggrandizement. Everything he says ultimately centers on himself. He lacks the humility to acknowledge errors or recognize his impact on others. He exhibits an extreme and pervasive lack of self-awareness.



Regarding sociopathic traits, Trump demonstrates:

1. Pervasive disregard for others' rights through racist, bigoted, sexist, homophobic, xenophobic rhetoric

2. Pathological lying—not occasional untruths but constant deception woven into his personality

3. Aggressive, mean-spirited behavior with reckless disregard for safety

4. Impulsivity with statements like "We're going to win against ISIS by bombing the shit out of them"

5. Complete lack of remorse or self-doubt



There are countless examples of Trump's complete lack of empathy, the more well-known ones include his mocking a disabled reporter, humiliating Gold Star parents whose son was killed in the Iraqi war, and dishonoring them by making disparaging remarks, when they were grieving the loss of their son. .


Perhaps the most damning evidence of his cold disregard for human rights and his bullying, vengeful, punishing and violent tendencies came from the Access Hollywood recording revealing misogynistic, predatory behavior, followed by twelve women reporting inappropriate advances. Trump denied all allegations and threatened legal action.

The Little Red Riding Hood of Disorders

Trump’s unique blend of narcissism and sociopathy is like the wolf in Little Red Riding Hood—dangerous and deceptive. By the time you realize the threat, the damage is done.

Grave Concerns

In 2015, Andreas Lubitz, a Germanwings pilot, deliberately crashed Flight 9525 into the French Alps, killing all 156 passengers on board. What makes this tragedy even more horrifying is that it was preventable. Lubitz had been flagged by psychiatrists as unfit to fly, showing clear signs of depression and suicidal ideation. Yet, he was allowed to take the controls.

The parallels to Donald Trump’s presidency are striking—and chilling. Both Lubitz and Trump displayed unmistakable signs of unfitness for their roles. Lubitz’s was rooted in acute mental health struggles, depression and homicidal ideation with plans and means. Trump’s stems from an amalgam of personality disorders—narcissistic, sociopathic, psychopathic (gaslighting), and delusional traits. Both were enabled by systems and individuals unwilling to act on the warnings.

Trump’s psychological profile is not just troubling—it is dangerous. His traits, behaviors, and decision-making patterns pose a risk of catastrophic consequences on a scale far greater than Lubitz’s.

What Must Be Done?

History is repeating itself, but we still have time to act. The Twenty-Fifth Amendment provides a mechanism to remove an unfit President. Government officials must formally request a fitness-for-duty evaluation conducted by qualified clinicians. Findings from such an evaluation should be used to build a case for impeachment.

If governmental action fails, the American people must mobilize. As citizens, we have the power to demand accountability, restore stability, and prevent catastrophic harm.

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